The role of momentary acute discrimination and cultural resilience in polysubstance use among adults from communities of color

短暂的严重歧视和文化复原力在有色人种社区成年人使用多种物质中的作用

• 批准号: 10585788
• 负责人: Jimi Huh
• 金额: $ 75.1万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-15 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585788
• 关键词: Acculturation; Acute; Address; Adult; Adverse effects; Affect; African American population; Alcohols; Asian Americans; Attention; Black, Indigenous, People of Color; COVID-19 pandemic; Cellular Phone; Cessation of life; Cigarette; Color; Communities; Coping Skills; Data; Discrimination; Disparity; Ecological momentary assessment; Electronic Nicotine Delivery Systems; Electronic cigarette; Environment; Ethnic Origin; Etiology; Event; Focus Groups; Future; Gender; Health; Hispanic Americans; Immigration; Individual; Inequity; Intercept; Intervention; Life Expectancy; Logistic Regressions; Marijuana; Measurement; Measures; Methods; Minority Groups; Modeling; Nature; Outcome; Pacific Islander; Pain; Participant; Personal Satisfaction; Persons; Phase; Play; Police; Policies; Population; Process; Public Health; Questionnaires; Race; Racial injustice; Recovery; Reporting; Research; Resources; Risk; Role; Stress; Structural Racism; Subgroup; Substance Addiction; Testing; Time; Tobacco use; United States; Variant; addiction; adult of color; aged; assessment application; combustible cigarette; comorbidity; coping; coping mechanism; design; digital; experience; hate crimes; health disparity; high risk; improved; infection rate; intersectionality; microaggression; novel; pandemic disease; pandemic impact; people of color; perceived discrimination; polysubstance use; post-pandemic; prevent; prospective; psychologic; racial population; racism; recruit; resilience; resilience factor; response; smartphone application; social; social stress; social stressor; stress management; stressor; substance use; theories

ABSTRACT. Structural and social inequities have historically impacted the health and wellbeing of Black, Indigenous and Persons of Color (BIPOC) in the United States, resulting in health disparities that were exacerbated by the COVID-19 pandemic, which coincided with a surge of discriminatory events and hate crimes targeting minority groups. Emerging research shows that substance use, especially polysubstance use (PSU), is increasing as a means to cope with the range of stressors and psychological consequences among BIPOC adults. The extent to which PSU as a maladaptive coping process unfolds and accumulates in the current context of the pandemic and racial injustice to perpetuate and potentially expand addiction-related disparities is unknown. Furthermore, the impact of coping responses, resources and resilience factors on these processes has not been extensively studied in all BIPOC subgroups. In the current proposal, we aim to capture the nature of daily variation in acute perceived discrimination and to examine how these variations influence PSU, with emphasis on evaluating predictors of resilience to stress. This information is critical to inform the design of context-sensitive interventions tailored to momentary circumstances in addition to person-level variables to prevent maladaptive coping strategies, including PSU. Building on our current user-centered, smartphone Ecological Momentary Assessment (EMA) app, we propose to conduct an exploratory-sequential mixed methods study. In Aim 1, we will use 6-9 focus groups (FGs; N~70) to better understand discrimination experience and coping resources in the context of intersectionality of race/ethnicity and gender in relation to PSU to inform context-sensitive EMA, refined during a pilot EMA phase. Subsequently, BIPOC adults who co- use 2+ substances (N=270) will be recruited through targeted digital ads, and will complete 7-day EMA every 3 months over 4 waves. In Aim 2, a cross-over, within-subject, repeated measure, observational EMA design will be used, and multi-level logistic regression models will be developed to determine the within-person effects of perceived discrimination on PSU and identify the underlying mechanisms. In Aim 3, we will model the prospective association between changes in discrimination and PSU using the multi-wave EMA data to examine the longitudinal effects of perceived discrimination contexts on changes in PSU among BIPOC adults. IMPACT. To the best of our knowledge, this is the first multi-wave EMA study that uses a social-ecological framework and a novel, culturally appropriate, real-time assessment design to determine the impact of day-to- day discrimination and PSU in BIPOC adults. We expect our study to uncover micro-temporal etiologies of PSU disparities across BIPOC adults that will inform future targeted interventions to ameliorate the effects of acute perceived discrimination on PSU and reduce addiction-related burdens disproportionately affecting BIPOC, an urgent aspect of post-pandemic recovery.

抽象的。结构性和社会不平等历来影响着黑人的健康和福祉， 美国原住民和有色人种 (BIPOC)，导致健康差距 COVID-19 大流行加剧了这种情况，同时歧视性事件和仇恨激增 针对少数群体的犯罪。新兴研究表明，物质使用，尤其是多种物质的使用 （PSU），作为应对各种压力源和心理后果的手段，正在日益增加 BIPOC 成人。 PSU 作为一种适应不良的应对过程在多大程度上展开并积累 当前大流行的背景和种族不平等使与成瘾相关的问题永久存在并可能扩大 差距未知。此外，应对措施、资源和复原力因素对这些因素的影响 尚未在所有 BIPOC 亚组中对流程进行广泛研究。在当前的提案中，我们的目标是捕获 敏锐感知歧视的日常变化的本质，并研究这些变化如何影响 PSU，重点是评估压力恢复能力的预测因素。此信息对于告知 除了针对个人层面之外，还针对瞬时情况设计情境敏感的干预措施 防止适应不良的应对策略的变量，包括 PSU。建立在我们当前以用户为中心的基础上， 智能手机生态瞬时评估（EMA）应用程序，我们建议进行探索性序贯评估 混合方法研究。在目标 1 中，我们将使用 6-9 个焦点小组（FG；N~70）来更好地理解歧视 在种族/族裔和性别交叉背景下的经验和应对资源 PSU 用于通知上下文相关的 EMA，并在 EMA 试点阶段进行完善。随后，BIPOC 成年人共同 使用 2 种以上物质 (N=270) 将通过有针对性的数字广告招募，并将每 3 完成一次为期 7 天的 EMA 月超过 4 波。在目标 2 中，交叉、受试者内、重复测量、观察性 EMA 设计 将使用多级逻辑回归模型来确定人内效应 调查事业单位所感受到的歧视并确定其根本机制。在目标 3 中，我们将建模 使用多波 EMA 数据，歧视变化与 PSU 之间的前瞻性关联 研究感知歧视环境对 BIPOC 成年人 PSU 变化的纵向影响。 影响。据我们所知，这是第一个使用社会生态学的多波 EMA 研究 框架和新颖的、适合文化的实时评估设计，以确定日常的影响 BIPOC 成人的日间歧视和 PSU。我们期望我们的研究能够揭示微时间病因 BIPOC 成年人之间的 PSU 差异将为未来有针对性的干预措施提供信息，以改善 对事业单位的严重歧视，并减少与成瘾相关的负担，产生不成比例的影响 BIPOC，大流行后恢复的一个紧迫方面。